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Individual
STEPHANIE M BURNETT
Active
Individual
STEPHANIE M BURNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT020704
PA
225100000X
Physical Therapist
Primary
PT09681
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000216468
ANTHEM
OH
01
—
000000218075
ANTHEM
OH
01
—
172775
MEDICARE PTAN
PA
01
—
214507
HEALTH ASSURANCE
OH
05
—
2344261
—
OH
01
—
34177311027
CARESOURCE
OH
01
—
34187731100
BWC
OH
01
—
34187731101
BWC
OH
01
—
34188311028
CARESOURCE
OH
01
—
6497047
UHC
OH
Enumeration date
10/19/2006
Last updated
11/22/2011
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